When the Simplest Solution is not the Right one: A Case of a Blunt Occam’s Razor

Abdominal pain in young females of childbearing age can be challenging when presenting to the Emergency department due to the atypical nature of presentation. Delays in diagnosis or misdiagnosis of appendicitis in this group can lead to higher rates of complications. Highlighting these cases will hopefully reduce the incidence of delayed and misdiagnosis and lead to better patient outcomes Here we present a case of a young female of childbearing age who presented with symptoms consistent with gastroenteritis, however ongoing abdominal pain prompted further investigation. The cause of the ongoing pain was confounded by the presence of an existing gynaecological condition and inconsistent presentation. A diagnosis of appendicitis was eventually made, and the patient proceeded to a laparoscopic appendectomy. On histopathological investigation the appendix was found to be gangrenous. The patient made a full recovery and was discharged from the hospital two days after surgery.